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Autism, Play and Social Interaction

by the same author

Autism and PlayJannik Beyer and Lone GammeltoftISBN-13: 978 1 85302 845 8 ISBN-10: 1 85302 845 2

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Autism, Play

and Social Interaction

Lone Gammeltoft and Marianne Sollok Nordenhof

Jessica Kingsley PublishersLondon and Philadelphia

First published in 2007by Jessica Kingsley Publishers

116 Pentonville RoadLondon N1 9JB, UK

and400 Market Street, Suite 400Philadelphia, PA 19106, USA

www.jkp.com

Copyright © Lone Gammeltoft and Marianne Sollock Nordenhof 2007

All rights reserved. No part of this publication may be reproduced in any material form (including photocopyingor storing it in any medium by electronic means and whether or not transiently or incidentally to some other use

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Library of Congress Cataloging in Publication Data

Gammeltoft, Lone, 1951-[Autisme, leg, og social udvikling. English]Autism, play, and social interaction / Lone Gammeltoft and Marianne

Sollok Nordenhof ; translated by Erik van Acker.p. ; cm.

Includes bibliographical references and index.ISBN-13: 978-1-84310-520-6 (alk. paper)ISBN-10: 1-84310-520-9 (alk. paper)1. Autism in children. 2. Social interaction. 3. Social skills. 4. Play.

I. Nordenhof, Marianne Sollok, 1958- . II. Title.[DNLM: 1. Autistic Disorder. 2. Child. 3. Interpersonal Relations.

4. Play and Playthings. WM 203.5 G193a 2006a]RJ506.A9A9844 2006618.92’85882—dc22

2006026313

British Library Cataloguing in Publication DataA CIP catalogue record for this book is available from the British Library

ISBN-13: 978 1 84310 520 6ISBN-10: 1 84310 520 9

Printed and bound by Amity Printingin The People’s Republic of China

APC-FT3929

www.jkp.com

Contents

preface 7

INTRODUCTION 9

EDUCATIONAL APPROACH TO PLAYING 12

Social interaction 12

Visualization – making a situation visual 12

ORGANIZING GAMES 14

The limits of the game 14

Where will the game take place? 14

What are we sharing? 15

Who takes part in the game? 19

Whose turn is it? 20

How should the materials be handled? 21

Where does the game start and finish? 22

Individual systems of support 25

Reminders 25

Losing and winning 26

EXAMPLES OF GAMES 28

Simple games 29

Putting in 29

Give and take 29

Complex games 32

Memory 32

Sound-lotto 33

Balloon game 34

Hide and seek 36

Shopkeeping 37

Game of dice 38

Spin the bottle 40

Pass the parcel 41

Mouse 42

Guessing game 44

Eenie, meenie 45

Star game 47

Games with social rules 49

Home 50

Exchanging toys 53

Shall we play with…? 55

Waiting game 56

Never mind 57

EPILOGUE 60

bibliography 62

index 64

Preface

This book arose from a desire we have had for a long time to pass onour experiences of how children with autism can improve their socialskills by playing together in a group.

It was developed from the experiences described in Autism and Playby Jannik Beyer and Lone Gammeltoft (1998) and is based on the the-oretical frame of reference described in that book.

This book is intended to be a source of ideas with practicalexamples of group games targeted at children with autism spectrumdisorder (hereafter referred to as children with autism). The ideas canbe used by both parents and professionals.

Our collaboration on play began in 1993 at Broendagerskolen, aschool for children with autism and learning difficulties. At that timethere was not much attention given to play as a way of working withchildren with autism, and the literature on the subject was verylimited.

As playing is so vital in children’s social development, we weresurprised that playing had such a low priority in working withchildren with autism, so we decided to investigate whether playingcould somehow make the social world more concrete and accessiblefor such children. That is what this book tries to illustrate.

We have taken inspiration from many different sources, not leastfrom the TEACCH Program (Treatment and Education of Autistic andrelated Communication-handicapped CHildren), and of course thechildren, who are the best indication of whether we are creating theright atmosphere for them to enjoy play.

We wish to thank those children and parents who have inspired us.

7

Our warm thanks also to psychologist Maiken Toemming andspeech therapist Anette Ly for constructive and critical comments onthe manuscript.

Finally, special thanks to psychologist Jannik Beyer, who has beenan inspirational sparring partner over the years.

Lone Gammeltoft and Marianne Sollok Nordenhof

8 autism, play and social interaction

Introduction

Playing occupies a large part of a child’s life, and playing andchildhood belong together. Through playing the child develops avariety of skills, not least in the social and emotional area. A child willalways find a space in which to play, and playing is also recognized as

9

Peter Hansen (1868–1928) Playing Children, Enghave Plads, Statens Museum for Kunst,

Copenhagen (Photo: Hans Petersen)

children’s very own occupation – their way of ‘being’ and expressingthemselves.

The impulse to play is spontaneous for the children – they playbecause they just can’t help it. Playing is an end in itself.

When children play together they intuitively prepare themselvesto tune into a kind of common ‘transmitter/receiver channel’ with ahigh degree of mutual attention to each other. This means that veryearly on in life they practise listening: waiting for and reacting to eachother’s signals – all that is implied in social interaction. They learnbasic social rules in a natural context; for instance that you have to taketurns and that you cannot choose or win every time.

Through playing children build up close emotional relations, inwhich they both copy and test themselves against each other. Playingis an activity driven by pleasure and can involve joy, enthusiasm,absorption, excitement, anger and seriousness – whatever heightensthe experience. All in all, playing must be considered fundamentallyimportant to the development of the child.

Some children, for various reasons, do not have a natural approachto playing – and children with autism, among others, belong to thisgroup. Children with autism find it difficult to interact socially withone another – and consequently they are often seen as children whocan’t learn to play with others. But if the play is organized bygrown-ups on the children’s terms, the children find a commonplatform where – through play – they can gain social experiences,which otherwise can be difficult for them to obtain.

When we talk about play, we are primarily concerned with thesocial aspect of it, focussing on the interaction between childrenwithout the intervention of grown-ups. The social world is difficult toexplain. We only get to understand it by engaging with it. One way forchildren with autism to do this is for them to play with their peers,whether they are other children with autism or other learning difficul-ties or their brothers or sisters. The games described in this book canbe enjoyed by and be of benefit to any child, and they are designedsuch that even if the children do not understand their purpose, thatneed not put them off playing.

The games that we describe all take place in a very organizedsetting, which gives the children the chance to see each other takingthe initiative and relating to each other. The games are all based onactual and visual materials used in ordinary children’s play. There areexamples of how a play environment can be built up through careful


organization and the use of visual cues, and how the togetherness ofchildren at play can promote social awareness. The purpose is to createa forum for children where a joint agenda and a shared understandingof what they are doing together ensures a common focus of attention.Clearly setting out the agenda using visual cues helps the childrenunderstand what they are going to be doing together and can helpthem moderate their own impulses and ideas.

Clearly defined limits, both physical and abstract, help childrenwith autism to concentrate on each other and in that way to respondappropriately in a social atmosphere.

As the social aspect is very difficult to clarify and visualize, thestarting point for the shared experience must be a concrete and visualstimulus. At the outset we took part in the games with the children, buteventually we discovered that our presence was too obtrusive – wewere interfering with the interaction between the children. From thattime onwards we realized that we had to be invisible to provide spacefor the children to observe each other. We altered the parts so that wehanded over the stage to the children and became ‘stage managers’,providing support through our work ‘backstage’.

As the games are simple and visually clear, the children do notneed any special instructions. Of course there are exceptions when thegrown-up can either teach the games to the children one by one orparticipate in the group until the new game is known to everybody.

The games must be continuously adjusted and adapted to eachindividual child and group so that the children get the degree of visualsupport that they need.

It is a good idea to videotape the children playing, so that it is notonly possible to see what succeeded and/or failed but also to find outwhat the children think is fun – which can be something completelydifferent from what we imagined.

A playgroup can consist of two to six children. The children arechosen according to a variety of criteria: temperament, level of socialdevelopment, personality and interests. For instance, it can be anadvantage to put together a temperamental girl with calmer friends ora quiet, cautious boy with younger children.

A game session typically lasts from 15 to 60 minutes.

introduction 11

Educational approachto playing

SOCIAL INTERACTIONFor most people, navigating the social world is intuitive and entirelynatural. We are well equipped to read and understand other people’sintentions and feelings. We receive a lot of information just by lookingat other people, and we instinctively try to create the best atmospherefor making social interactions succeed. How we do it is not easy toexplain.

Children with autism do not seem to be equipped with the sameinnate social awareness. That is why we must lend them a hand bycreating a framework for social interaction. Once we have we com-pensated for their social difficulties by creating meaningful limits inthe phsysical space and through rules, the children can take part insocial interaction without grown-ups being in control. The limitsmust support children in understanding what they are doing togetherand what they can expect from their interaction.

The following describes how you can create the ground rules forsocial interaction through the use of visual cues.

VISUALIZATIONThe use of visual cues can make the presence of a grown-up unneces-sary and improves the children’s understanding and gives them inde-pendence.

12

By visualization we mean the use of objects or images as visualcues to explain a situation. Children with autism have difficulty trans-forming their impulses into appropriate action. They have difficultycreating method and order in what they do (‘executive function’) andtheir actions often seem to be random and out of context. They alsohave difficulty grasping the meaning of a situation (‘central coher-ence’). For these reasons the children benefit considerably from struc-tured education in which schedules, records, instructions and the likebecome visual, specific templates for the planning by which the rest ofus navigate internally. Visualization is a support tool for a person withautism, like a white stick for the blind. Children with autism are oftengood at using their visual sense. By using visualization the children areable to function unaided in a range of contexts in which they wouldnormally depend on the support of grown-ups.

Visualizing the limits of games condition the children for takingpart in social interaction without grown-ups.

The advantages of using visualization in working with childrenwith autism are that:

• images are concrete and non-transient, unlike, for in-stance, words, gestures and signs, so the information isclear and unambiguous

• it provides information in a form that many children canunderstand more easily than auditory information (i.e.spoken language) (Hodgdon 1995)

• it is possible to edit the information by extracting and il-lustrating both the order of events and the meaning of thesituation.

educational approach to playing 13

Organizing games

Children with autism have great difficulty keeping their attention on ashared activity with others. They are often distracted by internal andexternal stimuli, or they become sidetracked by what we considerirrelevant details. They often have their own agenda and ideas of whatthe interaction should be about, but they never manage to communi-cate these ideas and intentions to each other. All of this makes itdifficult for them to take part in a community.

The setting up of a common agenda therefore becomes a funda-mental requirement for making interaction succeed for these children.

THE LIMITS OF THE GAMEIn the following we describe how setting limits to the game helps thechild to understand the common agenda.

Where will the game take place?Children without special needs can play anywhere. They choose thephysical space where the game is to take place and set it up together.They rarely have problems with a common focus and maintain themomentum of the game.

For children with autism it is necessary to set up, in advance, anenvironment where visual cues (physical limits) tell the children wherethe game is to take place. These limits can also help to minimize therisk of distraction by external stimuli.

14

A table with chairs is a good way of naturally limiting the area inwhich the game takes place (Figure 2.1). The chairs mark a place forevery participant. The children can observe the area and each otherand in this way they are better able to keep their attention on acommon activity. The table forms the starting point of the interactionand is the base where information is given out and stored, so thateverybody knows their place. Games that take place elsewhere can bedelimited in different ways, using mats, carpets, bookcases or a tapedarea.

What are we sharing?An important condition for playing with other children is that youagree on what you are going to do together. For children withoutspecial needs it is easy to come up with a game that can be played bymutual agreement, because they can normally find something incommon. Children with autism do not have extensive experience of

organizing games 15

Figure 2.1 A table helps to limit the area in which the game takes place

playing with other children and therefore often bring along their ownideas on what interaction should be about.

A significant part of establishing a common agenda is that thegame plan is given in advance and visualized so that the childrenknow exactly what they will be doing together and for how long theywill be together.

The simplest way in which to do this is to let the actual toysrepresent the game. In the beginning it may only be a single activitythat the children do together. Over time you add other simple activities,which are kept in separate boxes. The boxes are put in a bookcase orthe like, so that you can take them from left to right. When the last boxhas been used, the game is over (Figure 2.2).

This is a system that, in any context, provides children with informa-tion on how many and which tasks they need to do. Interaction andplaying demand much more from the children than just carrying outthe tasks; hence it is important that they do not have to use all theirenergy on understanding and executing the activity itself, but canfocus on doing it together with other children. The social aspect ofplaying a game is so challenging in itself that the content of the gamemust be simple and motivating.

A general game schedule with a clear visual indication of contentand order is a simple way of outlining the activity. It is a good idea tohave the contents consist of several small, short games rather than one


Figure 2.2 Materials for each activity are kept in separate boxes

larger, longer game. Shifting between the different games can be stim-ulating as long as the children are prepared for it.

The game schedule is numbered and each game is given a graphicsymbol attached with Velcro (Figure 2.3). One of the children is incharge of the game session, which means that he or she is responsiblefor following the schedule correctly. As the children take turns atbeing the one in charge of the game session all participants have achance to take responsibility in the course of the session (Figure 2.4).They often show great pride in taking on this role and get great satis-faction from following the system.

Graphic symbol number 1 is taken off the game schedule (Figure 2.5)and the corresponding toy put forward. When this game is finished,the toy is put aside and game number 2 begins. When the schedule isempty, the game session is finished. The last symbol, which is situatedto the right of the schedule, is the timetable symbol. This means that

organizing games 17

Figure 2.3 A numbered game schedule showing which games will be

played and in what order


Figure 2.5 Taking off the graphic symbols

Figure 2.4 Order for taking responsibility for the game session

each child is able to check their daily timetable to see what the nextactivity is.

The game schedule is clear and easy to follow. All the children areprepared for exactly which game they are going to play and this givesthem more energy to interact with each other.

As the children get to know the system, the child in charge cantake responsibility for putting together the game schedule.

Who takes part in the game?As children with autism have trouble taking the initiative to play withother children, it is essential that they know who takes part in thegame. This information can be on their daily timetable. It is alsoimportant to clarify visually the order of the participants to make thegame work as intended.

Giving a number to each child is a simple solution to this problem.The rule can be that the child in charge of the game always has thenumber 1 and that the other children get consecutive numbers and sitin this order. This way there are undisputed rules for which way topass on a prop and whose turn it is – number 1 always starts. All this is

organizing games 19

Figure 2.6 Numbers on the table show who sits where and the order of play

important so that children want, and understand how, to take part inthe activity. By visualizing the order from the beginning you preventdisappointments and children going off to do their own thing.

The numbers should be ready on the table (Figure 2.6), so thatwhen the children come to the table where the game is taking place,they find a number next to their picture corresponding with thenumber on the visual instruction. All the children are very quickly ableto find their assigned position and stick the number onto their tops, soit is visible to everyone else. It gives the children great satisfaction tobe able to read this information independently – comparable to therest of us breathing a sigh of relief when we arrive at a big dinner partyand find that there is a seating plan!

This kind of information can of course be presented in many ways,depending on the group of children you have. To make it easy for thechildren to handle the system of numbering themselves, the numberscan be printed on stick-on labels that are easy to attach to and removefrom clothes.

It is a good idea for the game schedule to include taking off thenumbers after the last game because, besides being a reminder, it alsoworks as a logical indication that the game is over.

Whose turn is it?An essential part of obeying the rules of a game is being able to taketurns. This means that the children are able to take turns at carryingout an activity and at the same time feel that each participant’s turn ispart of the same activity.

Children with autism do not have taking turns incorporated intotheir rules of interaction and for that reason they have to learn it differ-ently.

A cap can be a clear marker of who is taking the present turn –physically and visually. When the turn is done, the cap is passed on tothe next in line according to the numbers.

When the principle is understood by all, the cap is used only onspecial occasions, for instance if the children need to slow down orwhen the game does not include any other way of indicating whoseturn it is, such as a dice cup.

The ‘taking turns’ cap can remain an essential visualization of thecast in new and more sophisticated games, where it helps the childrento stay focused on the person performing the task and manage the turntaking.


How should the materials be handled?A problem shared by most children with autism, whatever their levelof function, is having trouble organizing materials. If the organizing isnot done in advance, important visual information can be messed up,materials can be mixed, and hence the game fails.

Organizing the materials is essential to the success of the inter-action.

By making it clear which materials belong together, how theyshould be used and where each game starts and ends, you achieve a wayof organizing materials or toys.

The toys are put in one spot: it can be a bookshelf, a desk or atrolley. The materials for each game are put into a box or are otherwiseseparated clearly (Figure 2.7).

In each game it may be necessary to show where the materials are to beplaced. For instance, small boxes can indicate where to put tricks in agame of cards (Figure 2.8). It might seem like a small detail, but it isimportant to keep count of how many tricks each person has. Withoutthe small boxes the tricks get mixed with the main pile or with the

organizing games 21

Figure 2.7 Careful organisation and separation of materials for different games facilitate

play

tricks of others. There is a high risk of the tricks falling on the floorand the time spent picking them up again spoils the flow of the game.

Besides, clear organization adds a certain joy to the game, whichwe may not share or quite understand, but which is very significant forchildren with autism – that things match and order exists.

Where does the game start and finish?A clear indication of when a game starts and finishes is very important.A typical way of indicating start and finish is to begin with all thematerials in one basket and put them into another basket as the gameproceeds. When the first basket is empty and the materials are all in thesecond basket the game is finished.

If the materials for the game are not clearly separated and whereyou start and finish are not indicated, at some point the children willlose track of where they have got to. They may even start all over againwith the materials that have already been used and hence lose interest.

In a game in which the children pull out cards from a basket, notonly should the baskets be very different, but the final basket (or box)


Figure 2.8 Small boxes indicate where to put tricks in a game of cards

should have only a small slot through which to post the used cards –like a postbox. In this way the children never have any doubt aboutwhich basket to pick up the cards from (Figure 2.9).

A clear indication of start and finish is possible with basically allmaterials.

For instance, blowing bubbles can be a difficult, unorganizedactivity to share. The start will be clear only to the first participant, butwhat indicates when it is the time to pass on the dispenser? And whendoes the game finish? In addition, blowing bubbles is an activity inwhich much can go wrong – the dispenser might be dropped orknocked over, bringing the game to a premature end. But if everythingis organized in one box, so you start by taking the ‘blowing stick’, dipit in the soapy water, blow the bubbles, put the stick back in thedispenser and pass on the box to the next in line, then the game isobvious and easy to play (Figure 2.10).

A small alarm clock or timer can be used as the finishing signal ingames for which the materials themselves do not provide a built-infinish (Figure 2.11).

organizing games 23

Figure 2.9 To avoid confusion, make it clear from where the children are to pick up the

cards and where to put them down when they have finished with them


Figure 2.10 Making the game obvious and easy to play

Figure 2.11 Use an alarm clock or a timer to indicate the time limits on a game

Your careful organization can help the children play unassisted andmotivate them.

The directions for use should be built into the material itself, thatis, they should be so visually clear that further explanation is necessaryonly when introducing new games. If the children themselves cannotdeduce the information from the material, the visualization is not suf-ficient. The sustainability of a game is measured by whether thechildren are immediately able to read what the game is all about. It isthe duty of the grown-up to make the game as clear as possible.

The children will find that they can cope with the situation whenit is clear:

• where the game takes place

• what each game is about

• who takes part in the game

• how the materials should be handled

• where the game starts and finishes.

The children now understand the common agenda and are ready torelate to each other.

INDIVIDUAL SYSTEMS OF SUPPORTIt is in itself a great challenge for children with autism to engage insocial interaction.

Individual systems of support may be necessary as a supplementfor some children to allow them to handle different situations to besteffect without assistance.

RemindersThese are visual expressions of appropriate behaviour that the childmust remember to abide by. A red line through a picture of what thechild is not supposed to do, such as picking one’s nose, is a precise andvery simple way of providing information. These ‘reminders’ can beattached to the table in front of the child, which helps the child toremember the information (Figure 2.12).

organizing games 25

Losing and winningTo many children it is difficult to lose – sometimes to the point ofinconsolability. This also applies to children with autism. This mayhave to do with the fact that when you win you obtain somethingtangible – a trick in a game of cards or a prize. When you lose you getnothing.

Based on this understanding of losing and winning, as an interme-diate stage, the loss can be made actual and visual if the children alsoget something when they lose, as a kind of consolation prize.

The example on page 27 shows a scorecard with the names of thechildren: if you don’t get tricks in a game of cards you get a stickerinstead (Figure 2.13).

In the game schedule that the children share – the one in whichthey can see which games are to happen– make it clear which gamesinclude ‘lose and win’. Next to the symbol of the game in question putthe symbol of the relevant scorecard. The children now know thatthey are to find the sheet with ‘no trick – take a sticker’ together withthe other materials.


Figure 2.12 Visual cues to prompt appropriate behaviour

organizing games 27

Figure 2.13 Consolation scorecard using stickers

Examples of games

The games in this book are primarily intended to increase children’sattention to each other, on the assumption that when children are in asocial situation that is free from any unnecessary ‘noise’ they have theopportunity of actually recognizing each other as active co-players.

Motivation is the principal element of playing – without motiva-tion there is no commitment. Motivation comes partly from being ableto play independently of adult intervention if the game has beencarefully prepared and organised. Much also depends on the nature ofthe game. In our experience, most games can be motivating, no matterwhat level of function the children have, as long as they:

• are simple

• are of limited duration and do not go on for too long

• have a clear aim, preferably competition.

Many of the games are based on other well-known ones, which havebeen visually adapted to make it easier for the children to involveordinary children (such as brothers and sisters).

The objective is that the children improve the quality of theirinteraction with each other. This is reflected in how much the childreninvolve each other during the game.

In the following we describe some games that the children canplay by themselves.

28

SIMPLE GAMES

Putting in

Description: For children who are at an early stage of development,interaction can be developed by letting the children take it in turns todo a playing activity involving exchange. By exchange we mean thatthe children share a toy by taking turns being the one to give and theone to receive. By using exchange, the transition from ‘only me’ to ‘weare together’ is emphasized.We start with activities that the children enjoy and that they can all dounassisted, such as putting simple jigsaw puzzles together, puttingblocks into a box, matching two identical pictures. These skills are notchallenging to the child; the challenge comes from the social elementof co-operation.

Procedure: Two children are seated in front of each other. The mate-rial consists of a basket with bricks and a container (Figure 3.1). Thefirst child puts a brick into the container and pushes the basket acrossto the second child (Figure 3.2), who puts a new brick into the con-tainer and pushes the basket back to the first child, and so on. Whenall the bricks are put in the container the game is over. Most children atan early stage of development are able to put bricks into a containerunassisted, i.e. the basic skill is present. The new demand is that thechild must learn to push the basket across to the other child every timehe or she has put a brick into the container, an action that thegrown-up can (physically) assist the child in doing at first. In ourexperience, most children quickly learn the process of taking turns as aroutine. However, be aware that in terms of development it is easier topush an object back and forth than it is to pass something over to eachother.

Give and takeProcedure: Another form of exchange is in the game of give and take.One child gives and the other takes (or receives), after which theyswitch parts so that they take turns at being the giver and the receiver.

The organization is concrete and visually clear as one child has theboard and the other child has the basket with the counters (Figure3.3). This replaces the direct involvement of the grown-up andincreases the children’s mutual attention.

examples of games 29


Figure 3.1 Exchange: The first child puts a brick in the box…

Figure 3.2 …and then pushes the box over to the other child to have a go

The children should be seated just within reach of each other, but notso close that the ‘giver’ can put the counter on the board him- orherself.

Purpose of both games: That the children see each other as neces-sary in order to succeed or to finish the activity through taking turns.


Figure 3.3 Give and take: one child gives (in this case a piece of jigsaw) and the other

receives

COMPLEX GAMES

Memory

Description: Memory is a very popular game, based on matchingtwo identical pictures. Most children with autism are good at this andfind it motivating.

The game is about the children taking turns to turn over two cardsat a time, and if these cards are identical they get a trick. The point is toget the most tricks. The game has a clear ending, namely when allcards have been turned over and the tray is empty. Even so, there areseveral factors in the organization that need consideration before thechildren are able to play the game independently.

A limited number of pictures increases clarity. This keeps the gamefrom slowing down and the players’ attention from wandering.

A tray with panelled (raised) areas prevents the pieces from beingmixed and at the same time shows whose turn it is, as the tray is easilypassed on from child to child as a complete set, unlike when the pieceslie on the table.

Small numbered boxes – one for each participant – make it easierto keep your own tricks in order and the box is appealing in itself(Figure 3.4).


Figure 3.4 Materials for a game of memory

Procedure: Child 1 starts by turning over two cards – if they areidentical, the child puts them in his or her trick box – and then passeson the tray to child 2 and so on. Each child is allowed to flip only twocards at a time, in order to cut the waiting time and at the same timeincrease the chance for everybody to take tricks. When the tray isempty the game is over.

Purpose: The children are motivated to keep a watch on each otherand relate to one another through repeating the same actions as eachother and expressing emotions such as joy and frustration, dependingon the outcome of the game.

Sound-lottoDescription: Sound-lotto is a game that consists of an audio tape orCD with different sounds from daily life, illustrated by correspondingpictures. The principle is easy and is about matching sound andpicture. The game is based on the sense of hearing. According to ourexperience it motivates the children to listen with great attention,which otherwise is very difficult for children with autism, as it can behard to connect sounds to something concrete from daily life.

The organization is important and helps to make it easy for thechildren to handle the game themselves.

Procedure: Child 1 has the box intended for the pictures (whichshow whose turn it is) and turns on the tape recorder. The child listens,matches the sound to the corresponding picture by putting the pictureinto the box and then passes on the box to child 2, who listens and soon (Figure 3.5). When there are no more pictures on the table the gameis over.

There are short breaks between sounds on the tape, so you don’thave to turn the tape recorder on and off during the process. In thisway the technical aspects do not interfere with the flow of the game.

Purpose: As in Memory, except that there is no winner in this game,which can be an advantage to some children.


Balloon gameDescription: The balloon game requires the children to keep aballoon in the air without it ever touching the floor.

Procedure: The children sit or stand around a table. Child 1 can startby hitting the balloon across to one of the other children, who thenhits it across to a third child, and so on (in random order) (Figure 3.6).The small alarm clock indicates when the game is over.

Depending on their level of ability a rule can be added that thechildren count how many times the balloon is hit without touchingthe floor (Figure 3.7).


Figure 3.5 Sound-lotto: the player listens and selects from the table the picture

corresponding to a sound


Figure 3.6 Balloon game: the children must focus on each other…

Figure 3.7 …to keep the balloon from touching the floor

Purpose: The children are motivated to co-operate and focus on eachother in order to target their ‘shots’ as best they can. At the same timestrong impulses in younger children can be restrained by making themremain seated. Older children are motivated by counting and breakingrecords. The game often arouses spontaneous joy and other emotionaloutbursts.

Hide and seekDescription: The children take turns to hide an object for one of theother children to find. There are two active participants in this game:the child who seeks the object and the child who hides it.

An important starting point is to make the object a small tickingclock in order to simplify the process of finding the object. The noisemotivates the children to listen carefully in order to find the hidingplace and at the same time this helps to keep the other children’sattention on the person who is trying to find the clock.

It is important to limit the area in which the object can be hidden,so that the children know the ground covered by the game and are notdistracted by irrelevant stimuli.

Procedure: The children sit in a circle or around a table. Child 1leaves the room and the last child hides the clock, while the other chil-dren observe. Then everybody calls for child 1, who comes in and lis-tens in order to find the hiding place. You can agree in advance that theother children may help by giving verbal support (‘you’re gettinghot/cold’) or by pointing, but they must all remain seated. The keyfactor is that the children keep their attention on each other. Thenchild 2 leaves the room, while child 1 hides the clock, and so on. Thegame is over when everybody has tried both hiding the object andfinding it.

Purpose: Through playing, the children can achieve an understand-ing of hiding something from others, which can be a difficult conceptfor children with autism. Hiding something means understandingthat you know something that others do not know and which you arenot supposed to reveal. This can be difficult when you mainly under-stand the world from your own perspective, but it can normally belearned as a rule of the game.

At the same time the children are challenged to maintain attentionon the two principal people: first the child who is to hide the clock and


then the child who is to find it. This game can be a precursor forplaying hide and seek with people, where you replace the clock withone of the children, who hides – and later on with all the childrenhiding from the one child who is supposed to find the others.

In this way you can simplify a relatively complicated game such ashide and seek by dividing it into several elements that are learned stepby step.

ShopkeepingDescription: Shopkeeping is a simple game that most children haveplayed for generations. This version is based on exchanging pictures;it was inspired by PECS (Picture Exchange Communication System),which allows children who are unable to communicate verbally to usepictures as a communication system. The game is also popular amongchildren who can talk and would not otherwise use PECS, because thesystem is based on the principle of being given something.

Procedure: The children take turns being ‘shopkeeper’ (wearing theturn-taking cap). The shopkeeper stands behind a counter with differ-ent kinds of goods. The pictures of the goods are hung on a board,kept apart from the counter (Figure 3.8). The other children can


Figure 3.8 Shopkeeping: pictures of the goods are attached to a wall or board

choose whatever they want by taking a corresponding picture; theygive it to the shopkeeper, who will then give each child the requestedgoods (Figure 3.9). Each child puts the used picture back on the boardwhen he or she has finished ‘using’ or eating the goods. An alarmclock indicates when the shopkeeper must switch parts, which meansthat he or she passes on the cap to child 2, and so on. The game is overwhen all the children have been the shopkeeper.

Purpose: The children play with the exchange routine through dia-logue: approaching a receiver (the shopkeeper) directly, they deliver amessage (a picture) in order to receive an answer (the requestedobject).

Game of diceDescription: The children sit around a table on which there is a cupwith a dice, which has colours instead of numbers, and a bowl con-taining a limited number of sweets in different colours.


Figure 3.9 The shoppers hand over the pictures to the shopkeeper in exchange for the

goods

Procedure: Child 1 throws the dice and takes one sweet in whatevercolour the dice shows (Figure 3.10). The cup is passed on to child 2,who throws, and so on. The game is over when there are no moresweets left in the bowl. This is very simple and at the same time moti-vating.

Comment: There are some ‘jokers’ in the game. What happens if achild throws a green and there are no green sweets left? You get noth-ing. The basis of the game is that the rules have to be followed and inthis case it is the dice that decides.

Purpose: Through this simple game of dice the children learn thatthe outcome is not always in your favour when you are with others,but fortunately you have another turn in a little while and perhaps you


Figure 3.10 Game of dice: the colour on the dice indicates the colour of the sweet that

can be taken

will be luckier then. The children are thus encouraged to keep an eyeon each other to ensure that the rules are followed.

Meanwhile the lucky children can gloat over their luck – all in all,emotional expressions that provide important social experiencesabout yourself and others.

See also Never mind, as on page 53.

Spin the bottleDescription: Spin the bottle is a familiar game, in which the childrensit with a bottle placed in the middle. The person whose turn it is spinsthe bottle. When the bottle stops the person at whom the bottleneckpoints performs an action decided by the person who spun the bottle(Figure 3.11).


Figure 3.11 Spin the bottle: the bottleneck points out who is to mime next

To make it easier for the children to play the game, what the personpointed out by the bottleneck should do may be specified in advance.The visualization consists of different cards with a picture and/or textdescribing simple activities (clapping, waving, jumping, and so on)organized in some sort of a card holder, so that they can easily bepassed back and forth between the participants.

Procedure: The children sit on the floor or around a table. Child 1spins the bottle and the child pointed out by the bottleneck draws acard and does whatever the card indicates. Then the card is put into abox through a slit in the lid, so that the card disappears. Then thischild spins the bottle, and so on. When there are no more cards in theholder the game is over.

If the bottle is too difficult to handle the game can be simplified bythe children taking turns to draw cards.

Purpose: The children learn that not everyone necessarily gets thesame number of turns because the order in this game is random (youcan’t predict where the bottleneck will point). Besides it can be diffi-cult to agree on who is being pointed at when the bottle is pointing atthe space between two children. These issues can challenge the chil-dren to try to find a solution themselves, which is a good opportunityfor them to practise reaching an agreement.

Pass the parcelDescription: This game is a popular parlour game in which the con-testants throw a dice in a limited period of time in order to win the oneparcel that is in the game. The game requires one toy wrapped inpaper, a dice (preferably with only three numbers in order to speed upplay) and a small alarm clock. The principle of the game is simple, it isvisually clear and there is a clear indication of when the game startsand ends.

Procedure: The children sit around a table or in a circle on the floor.Child 1 throws the dice and then passes on the cup to child 2, and soon, and whoever gets the number 3 on the dice can take the parcel (butnot open it) and put it in front of him or her. The children continuethrowing the dice and every time one of them gets the number 3 he orshe can take the parcel. Whoever has the parcel in front of him or herwhen the alarm clock rings can open the parcel and the contents are


shared or used in turns. It is not something that the winner gets tokeep to him- or herself.

The timeframe can be adjusted according to how many childrenare taking part in the game. The optimal number of participants is fourto five children.

Purpose: In this game there is a good ‘flow’; the clock helps to speedit up and the children are motivated to keep an eye on each other. Theelement of competition stimulates the children to express, and tonotice in themselves and in the others, spontaneous emotions such asexcitement, expectation, joy, frustration – all of which reflect a com-mitted interaction.

MouseDescription: Mouse involves putting treats such as raisin, popcorn orsweets on a colourful patterned plate. The child whose turn it is eatsthe treats one by one until he or she takes the ‘mouse’, which the otherchildren decided on beforehand (Figure 3.12). The colours andpattern on the plate help the children select and remember the‘mouse’. You could also use a plain plate and different coloured sweets,but it works best with only one of each colour.

Procedure: The children sit around a table. Child 1 leaves the room(or closes his or her eyes), while the other children must agree on oneof the treats to be the ‘mouse’. Then child 1 comes back to the tableand starts eating one treat at a time, while he or she keeps an eye on theother children’s reaction. When the child picks up the ‘mouse’ theother children shout ‘MOUSE’ and this treat must not be eaten. Thepoint is of course to get as many treats as possible. Then child 2 leavesthe room and so on, until all of the children have had their turn.

Comment: Depending on the group of children involved, this gamemay require some adjustments for the children themselves to be ableto control it.

Agreeing on selecting a ‘mouse’ at first is challenging for thechildren; hence the other rules are simplified as much as possible inorder to get the interaction to function.

Giving the children numbers may be essential for the childrenthemselves to handle the order in which they are to take turns.


The ‘taking-turns’ cap can be used as a further visualization ofwhose turn it is, in order to highlight the current player to the otherchildren and so focus their attention on him or her.

Before you start the game you can read out some rules for playingMouse to the children. For example:


Figure 3.12 Mouse: the player can take treats from the plate until he or she picks the

‘mouse’

When we play Mouse I must remember:

• to point at the treat that we have agreed to be the

‘mouse’ (and not say it out loud)

• that whoever has the ‘taking-turns’ cap must eat

only one treat at a time until the others call out

‘MOUSE’

• that, when it is my turn, I do not know which treat

the others have chosen to be ‘mouse’

Purpose: In this game you can be unlucky and get nothing! Again wehave a game based on maintaining attention on each other. But thereare other elements in the game, for instance being able to change per-spective and strategy. Through playing the children get an under-standing of keeping the ‘mouse’ secret from the child in question,which means that the other children have a different perspective onthe game from their playmate. In addition it becomes clearly necessaryto select a new treat to be the ‘mouse’ every time (to change strategy)in order to ‘fool’ the playmate.

Guessing gameDescription: The guessing game is about the children taking turns tomime an activity or an emotion; the other children then have to guesswhat is being mimed.

Procedure: The children sit around a table. Child 1 picks a card andmimes whatever the words or picture on the card indicate (withoutshowing the card to the others!) and the other children try to guesswhat the mime signifies. Then the card is put in a ‘completed’ box andthe card holder is passed on to child 2 and so on (Figure 3.13). Thegame is over when there are no more cards left.

Comment: It is a good idea to start with simple actions – for instanceeveryday routines. It is easier for both the miming child and the otherchildren to relate to an activity such as combing your hair, drinking,brushing your teeth, dancing. When the children have become famil-iar with the idea of the game, it can be extended to miming morecomplex actions and emotions.

Purpose: The object of this game is to direct the children’s attentionto reading other people’s body language and imitations (which can be


• that I do not know how many treats I will get

• that sometimes I will get lots and sometimes I

may get none, but that is OK

• if I do not get any treats, I can try again next time

we play Mouse.

difficult for children with autism) in a simple miming game. The chil-dren are encouraged to keep their attention on the person doing themime. In addition the children learn that they can put into actionvisual information from a card, without first showing the card to theothers.

Eenie, meenieDescription: Children’s rhymes are a way in which children can playwith the language in a rhythmical way, which most ordinary childrenlove, especially because there is often a social element in saying theserhymes together. To many children with autism rhymes do not appealin the same way. In order to get the children to see the point of sayingthese rhymes and at the same time make it a coherent social interac-tion, you can use a box with small edible treats.


Figure 3.13 Materials for the Guessing game

drive

play the trumpet

hammer a nail

drink

fishing


Figure 3.14 Eenie, meenie…

Figure 3.15 …minie, moe

Figure 3.16 Whoever gets to say ‘toe’ can open the

box and take a treat

Procedure: The children sit in numerical order on the floor or arounda table. They say the rhyme as the box is being passed from child tochild (in numerical order): Eenie (1) – meenie (2) – minie (3) – moe (4)– catch (1) – a tiger (2) – by the (3) – toe (4). The child who gets thebox on ‘toe’ can open the box and take a treat (Figures 3.14 to 3.16).The game is repeated until the box is empty (adjust the number oftreats to the number of children).

Who gets the ‘toe’ depends on the number of children. When twochildren are together they will get the ‘toe’ every second time. Whenthree children are together the rule is that whoever got the ‘toe’ shallbegin the next round, and so on. That way everybody gets the ‘toe’.This can be visualized for the children on a plan.

Purpose: This is a game that focuses on taking turns and start-ing/stopping. The passing on of the box visualizes the rhyme bybasing it on action in a tangible and motivating way. Some childrenwith autism are good at repeating and remembering linguistic expres-sions; thus they are given an insight into social experience by sayingthe rhyme together with other children. At least one of the childrenmust know the rhyme.

Star gameDescription: The star game is homemade and is based on principlesknown from other board games. It consists of a board with differentlycoloured areas, correspondingly coloured cards with a picture or sometext, counters, a dice and sweets (Figure 3.17).

The cards and the sweets are arranged in a box with compart-ments. This version of the game requires that at least one of the partici-pants is able to read.The board is divided into differently coloured areas with a ‘Start’ and‘Finish’. The cards are divided into five different categories:

• factual questions such as ‘What is the capital of England?’

• personal questions such as ‘Where did you spend yoursummer holiday?’

• riddles

• jokes

• treats.


Each category has its own colour, which corresponds with an area onthe board. In addition there are some white areas; landing here meansthat the player has to miss a turn. On some of the areas there is a star,which allows the player to move to the next star.

Procedure: The children sit around a table with the board in themiddle. Every child selects a counter (or is given a numbered piece)and puts it on ‘Start’. Child 1 controls the box with the cards andtreats, and also reads out the questions throughout the game. (Thistask can be given to another child if child 1 cannot read.) Child 1throws the dice and moves his or her counter according to the numberon the dice. Depending on which colour the counter lands on, thechild gets a question from the corresponding category or wins a treat.Whichever child is the first to reach ‘Finish’ is the winner and thegame is over.

Purpose: The children learn to use simple topics of conversationwhen interacting with each other. Children with autism are definitelynot used to small talk. This means that they often do not know very


Figure 3.17 Materials for the Star game

much about each other, for instance where they live or whether theyhave any brothers or sisters. They may not even know that they canask one another in order to get information. All in all they are not usedto exchanging factual knowledge with each other, making jokes andtelling riddles. The game is a formalized exercise for the children intaking turns at this kind of exchange.

GAMES WITH SOCIAL RULESThe following are some examples of how children with autism canlearn the rules of social interaction through play, when those rules areexpressed in terms of a game.

Social rules are necessary in order to make society function. Aschildren acquire more social experiences, the need for rules to governtheir interactions increases. Being able to follow such rules meansunderstanding that it is the rules that decide in any given situation andnot their own needs.

This means that the child must learn to accept that a situation doesnot always benefit him or her. This is not easy for children, whocannot help but see the world from their own perspective, but it isessential for coping in the social world. How then do we teach thechildren this? We do it by putting the children in situations wherethey, so to speak, absorb the rules according to the principle of‘learning by doing’. So, instead of protecting the children from situa-tions of conflict, we make the conflict into an experience that offersthe children possible actions. Only in this way can we prepare thechildren for handling the situations themselves in future – a sort ofearly conflict resolution.

The advantage of children learning through playing is that we setup situations in which the children are mentally relaxed and not reallysubject to social pressure. Social rules cannot be taught in socialrelations in which the child is in the middle of a crisis.

The inspiration for using different graphic symbols as tools isdrawn from Picture Exchange Communication System (PECS).


Home

If we think back to our own childhood, we realize that we learnedmany social rules through playing with other children. This happenedwithout our knowledge; the rules were absorbed subconsciously.

Among such rules is, for instance, the concept of ‘home’. Most ofus probably recall shouting ‘HOME’, just before we were caught – thefeeling of being able to choose a break or a haven when we were mostunder pressure.

Grown-ups can also benefit greatly form the concept of ‘home’,albeit a mental refuge, to switch off for a while to gather theirthroughts before rejoining the real world.

Children with autism tend to be poor at this mental housekeeping.They receive impressions unsorted and hence they are often over-whelmed by stimuli from their surroundings. The consequence can bethat the children switch off or feel unwell and have difficulty main-taining concentration.

Hence children with autism are dependent on us to sort impres-sions and stimuli for them. Structured teaching, based on visualizingeveryday activities, demonstrates that, when this sorting succeeds, thechildren relax, focus on the task at hand and hence are better able toachieve their potential.

But how do you sort stimuli in the social arena? In social relations,which are so demanding for a child with autism to participate in,children need to learn how to take time out without physicallyleaving.

Experience shows that if we translate and clarify the rules of thesocial world in the children’s terms, they are actually able to learn andmake use of these rules.

Description/purpose: To give the children an understanding ofwhat ‘home’ means, the grown-ups must stage situations that goslightly beyond the children’s boundaries – situations that cause thechildren to need to step aside. Teasing is an example of a situationwhich is often difficult to handle, so it can help to teach the children totease each other in a way that is controllable. That is to offer the chil-dren an actual (emotional) experience of being able to tease somebodyin an acceptable and clearly defined way, without the child or the rela-tionship falling apart.

To some children a ‘social script’ can be a useful starting point fora representation of ‘home’ (Figure 3.18).


This way the children gain an understanding, through play, of theconcept ‘home’.

Procedure: Two or three children sit at a table and the materials andrules of the game are introduced to the children (Figure 3.19).

• Child 1 draws a card from a holder (containing eight toten different cards).

• The child does to the other children whatever is shown onthe card; for instance, tickle with a feather, stick his or hertongue out, use provocative words.

• When one of the children feels put under pressure, he orshe can put on the red cap and say ‘HOME’, and step out ofthe game (Figure 3.20).

• When the child takes off the cap he or she re-enters thegame.

• Now child 2 draws a card, and so on.

• When the card holder is empty the game is over.


HOME

I play with the other children.

Sometimes I need to step aside from the game = HOME.

When I am HOME, I shall put on the red cap.

When I am HOME, I am not a participant in the game.

When I want to play again, I take off the cap.

Figure 3.18 A ‘social script’ is a useful starting point for a representation of

‘home’


Figure 3.19 Materials for the Home game

Figure 3.20 Wearing the cap means

being ‘home’ – and not

participating in the game

This way, through playing, the children quickly get an early under-standing of the concept of ‘home’ in a simple and fun way.

Subsequently the grown-ups must be sure to integrate the conceptin the children’s everyday lives by making the cap available to thechildren wherever they go, inside as well as outside the home.

Over time the ‘home cap’ can be replaced by a graphic symbol.

Exchanging toysDescription: When children with autism learn to play together theyneed some literal ‘social tools’ to help them handle being together.

Some children tend to become so absorbed in a particular toy thatthey show no real interest in togetherness. Others find it difficult toapproach each other in an appropriate way.

So, it is the task of the grown-ups partly to make it meaningful forthe children to involve each other in the game and partly to providethem with clear rules for how this can be done.

Procedure: The children can learn to interact through playing withthe help of a ‘swap card’. To begin with, the rules are made as simple aspossible, in order to make the exchanging routine become the mainpurpose. Start with just two children together, each with a motivatingtoy. The ‘swap card’ is put on the table between them, fastened withVelcro.

Most children will quickly learn to use the ‘swap card’ (Figure3.21), which means taking the card, giving it to the playmate andsaying: ‘Shall we swap?’. The motivation is to try out the toys: firstone’s own and then the playmate’s (Figure 3.22). This gives rise to theneed for exchange.

Over time you can add more toys. Give each child a basket withdifferent but complementary toys (toy figures, doll’s house furniture,and so on). The point is the toys are different so the children aremotivated to negotiate with each other.

When the children have learned the exchange rule as a routine,introduce the ‘swap card’ in everyday situations.

Purpose: Experience has shown that most children very quickly learnthat the ‘swap card’ has a direct impact on the playmate, which other-wise can be hard to obtain without conflict. The card provides bothsides with an opportunity to respond, thereby increasing their atten-tion towards each other – so instead of just grabbing the toy you want



Figure 3.21 ‘Shall we swap?’

Figure 3.22 Exchanging toys

(and the game falling apart) the card sets the stage for negotiation,which means dialogue, before the desired action is executed (and thegame goes on).

Shall we play with…? YES/NODescription: Many children with autism find it difficult to initiatemoves to play with other children. And if they have tried it is oftenlinked to negative experiences. However, if the children have a formal-ized tool to ask each other ‘Shall we play?’ and at the same time veryprecisely indicate what they should play, the children themselves havea basis for approaching each other without being misunderstood.

Procedure: Two children sit in front of each other at a table. Picturesof possible toys are fastened with Velcro on a wall or board nearby(Figure 3.23).

Child 1 chooses one of the pictures from the board and sticks it on to astrip of Velcro, hands it over to the playmate and asks (if he or she isable to use spoken language): ‘Shall we play with building bricks?’The playmate replies by putting the YES or NO symbol on top of thepicture. If the answer is YES, child 1 picks up the toy, which is nearby,


Figure 3.23 Materials for Shall we play with…? YES/NO

and the children play until the game reaches its own conclusion or analarm clock sounds. The children take turns asking and answeringeach other. If the answer is NO the child who asked must play with thetoy alone or come up with another suggestion.

Purpose: In this game the children have a tool that helps themapproach and await each other’s reply in a formalized way – the sub-stance of a dialogue.

The children learn that it is OK to disagree and that you can solveit by asking again.

Waiting gameWhen you wait for something it means that you cannot expect to have allyour desires satisfied at once. In other words, waiting for somethingmeans postponing your desires. This is difficult for most people –think of a tailback during rush hour. All young children must learn towait and all parents know that it does not happen without difficulty.

For children with poor imagination, an understanding of theconcept is essential in order to be able to relate to it. They need to learnthat waiting for something means postponement and not never.

In order to prepare the children in the best possible way to handlea postponement of their desires, a visualization of the concept can be agreat help.

Description: The waiting game uses the authorized PECS-symbolfor ‘wait’ (fastened with Velcro to the middle of the table) and graphicsymbols of different options (fastened to a strip). The correspondingactual objects are placed a short distance from the table (Figure 3.24).

Procedure: Child 1, wearing the cap, asks child 2 ‘What would youlike?’ and at the same time hands over the strip with the graphic sym-bols. Child 2 chooses one of the pictures and hands it back to child 1,who says ‘wait’ and gives child 2 the waiting card. Child 1 leaves thetable and picks up the requested object, returns to the table, takes thewaiting card and hands the object to child 2. When the object hasbeen used or eaten child 1 hands over the cap to child 2, who askschild 3 and so on, until all the children have tried both roles.


Purpose: This way the children grasp the concept in a motivating andaccessible way through play.

The graphic symbol for ‘wait’ can easily be used in relevant situa-tions in the children’s everyday lives.

Never mindWe got the idea of the Never mind game from a boy in Broendager-skolen who used the expression ‘never mind’ to defuse conflict situa-tions, which are inevitable in day-to-day social interactions.

To say ‘never mind’ is analogous to the concept ‘home’. It involvesa more mental acceptance of the fact that social rules are not always toyour advantage but that your world does not fall apart because of it.

Description: A simple game of dice with coloured dice and sweets (asdescribed in Game of dice on page 38) is an ideal way to introduce theconcept. The ‘never mind’ card is put in the middle of the table with


Figure 3.24 Materials for the Waiting game

frog chocolate


Figure 3.25 Whenever a child makes a throw of the dice that does not result in a

sweet, he or she can take the ‘Never mind’ card

Figure 3.26 Never mind!

Velcro (Figure 3.25). Whenever a child makes a throw that does notresult in a sweet, he or she can take the card and say ‘never mind’(Figure 3.26).

Purpose: Children learn to handle the feeling that everything is notalways to your advantage when you play by the rules.

Experience shows that when children are given the opportunity tobe specific about this feeling – by taking the card and saying ‘nevermind’ out loud – the situation is put into perspective. In this way thechild in crisis reduces his or her impulses to, for instance, hit or destroysomething or have a tantrum, and in many cases they find it easier toaccept the situation.

Simply stated, the ‘never mind’ card is a visualization of the innerthought processes that the rest of us use in order to handle or adapt todisadvantageous situations.


Epilogue

To many people the joy and the meaning of social life is in together-ness itself – sharing experiences, thoughts, reflections, joys andsorrows.

To people with autism social life is often more of an obstacle,which does not make sense until it is translated into tangible and man-ageable values.

But to translate something that is based on intuition and feeling is,of course, only partly possible.

However, we are convinced that children with autism can engagein the social world through play, but this does not alter the fact thatthey will find it hard work. Social interaction is a challenging area forchildren with autism, and in the kind of play that we have describedwe are dealing with small steps in a very simplified translation.

But we see that the children have an increasing need to repeat thepositive social experiences that occur whenever the settings make itpossible for them to start playing unaided. And we see them spontane-ously offering each other emotional responses during the games whenthey understand the premise of togetherness.

And that is a huge step towards what we consider a human right: tobe able to share and exchange experiences on your own terms.

The games can easily be transferred to the home setting. We haveknown parents who have gathered the accessories for some of thegames in a suitcase, which they take along to social gatherings withfamily or friends. In this way their child can initiate play with theother children there.

60

To create suitable limits for playing involves a real respect for thesechildren’s perceptions, so that we do not necessarily force our way oftogetherness on to them but all the time are aware of what they findmotivating, meaningful and fun. The children are the main charactersand the grown-ups are backstage when it comes to the testing andadjustment required to develop the games.

Through this book we hope to have inspired others who workwith children with autism to increase the opportunities for them toplay together.

epilogue 61

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bibliography 63

Index

Balloon game 34–6

body language, reading 44–5

complex games 32–49

consolation prizes 26–7

Dice game 38–40

Eenie, meenie game 45–7

exchange 29–31, 38

Exchanging toys game 53–5

games

complex 32–49

directions for 25

order of participation

19–20

setting limits 14–25

simple 29–31

with social rules 49–59

support systems 25–7

see also names of individual

games

Give and take game 29–31

Guessing game 44–5

Hide and seek 36–7

Hodgdon, L.A. 13

Home game 50–3

limits of games

clarity of rules 25

handling materials 21–2

participants 19–20

physical 14–15

sharing 15–19

start and finish 22–4

turn-taking 20

see also social rules

listening games 33–4, 36–7

losing, consolation for 26–7

luck, games of 38–40, 42–4

materials, organizing 21–2

Memory game 32–3

miming 44–5

motivation 28

Mouse game 42–4

Never mind game 57–9

order of participation 19–20

Pass the parcel 41–2

PECS (Picture Exchange

Communication System)

37, 49

Putting in game 29

reminders 25–6

rhymes 45–7

rules see social rules

scheduling tasks 16–19

Shall we play with...? Yes/No

game 55–6

sharing 15–19

Shopkeeping game 37–8

simple games 29–31

social interaction 12

social rules 10, 49

games with 50–9

see also limits of games

social scripts 50–1

social tools 53, 55, 56

Sound-lotto game 33–4

Spin the bottle game 40–1

Star game 47–9

starting and finishing games

22–5

stickers 26–7

support systems

consolation for losing

26–7

reminders 25–6

using visualization 12–13

teasing 50

timing of games 23–4

tools see social tools

turn-taking 20, 29–31, 37–8,

43, 47

visualization 12–13, 19–20,

25–6

Waiting game 56–7

winning 26–7

64

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